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EOLIA

TreatmentCritical Care2018
PurposeTreatment
FieldCritical Care
Year2018
Key FindingECMO for severe ARDS: non significant primary result, then a famous Bayesian reanalysis

About the Trial

The ECMO to Rescue Lung Injury in Severe ARDS trial randomized 249 patients with very severe ARDS to early VV ECMO or conventional management with transfer allowance. Mortality at 60 days, the primary endpoint, was 35 versus 46 percent, not statistically significant, and emergency crossover of 28 percent of control patients to ECMO complicated interpretation. The trial was stopped early for futility. The 2018 publication, followed by a Bayesian reanalysis by Goligher and colleagues suggesting a probable mortality benefit, ignited debate about crossovers, stopping rules, and statistical interpretation. With the earlier CESAR trial, EOLIA supported ECMO as a rescue option for refractory ARDS at experienced centers, and it was used widely during COVID 19 surges.

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